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RECENT EFFICACY DATA OF TOLTRAZURIL AGAINST

TURKEY COCCIDIOSIS IN CAGE AND FLOOR PEN STUDIES

R. Froyman, T. Irion and G. Greif

Bayer Animal Health Business Group, D-51368 Leverkusen, Germany

Adequate control of coccidiosis remains a continuing turkey health topic. Apart

from increased mortality, E. meleagrimitis and E. adenoeides, the 2 most

common pathogenic Eimeria species, provoke clinical disease with reduced

feed intake and decreased performance (Edgar, 1987; McDougald, 1998).

Despite improving husbandry standards and the strategic use of in-feed

anticoccidials, clinical outbreaks still occur and are encountered in growing

turkeys, commonly between 3 and 5 weeks of age. Early Haemorrhagic

Enteritis (HE) infections, HE vaccination, flock relocation or transition from

starter to grower feed are reported as triggering agents. Hence there is a need

for efficacious anticoccidial drugs to treat coccidiosis in the drinking water.

Toltrazuril (Baycoxâ), a symmetrical triazinetrione, is a recognised compound

for the treatment of coccidiosis infections in poultry and mammals. Since many

years Baycox has a proven record of efficacy against chicken and turkey

coccidiosis in the field.

The efficacy of toltrazuril has been shown in multiple controlled studies (Greuel

et al., 1989; Greuel et al., 1991; Pashov and Koinarski, 1994). These trials

consisted of artificial challenges with E. meleagrimitis, E. adenoeides and/or E.

gallopavonis in 2 week old turkeys followed by one or two treatment courses

with 25 ppm toltrazuril in the drinking water for 2 consecutive days. The aim of

the work reported here was to confirm the efficacy of a single two day treatment

course with Baycox at the recommended daily dose of 7 mg/kg and to examine

whether increasing this dose would improve efficacy. An artificial challenge

model was developed in house, compliant to GCP guidelines, to the specific EU

Directive (81/852/EEC, Ref. 111/9289/90) for anticoccidials used for the therapy

of coccidiosis in turkeys and geese, and to the FDA guidance (guideline “40” for

evaluating the efficacy of anticoccidial drugs) . In this challenge model 10 to 12

day old turkey poults were challenged with reference Eimeria isolates of known

pathogenicity (CVL, Weybridge, UK), kindly provided by R. Marshall. The

coccidiosis infections, either E. meleagrimitis or E. adenoeides, were titrated in

susceptible turkey poults in order to define an infectious inoculum of sporulated

oocysts that provoked approx. 50 % weight loss compared to untreated,

unchallenged controls. Challenge doses varied between 50,000 and 100,000

oocysts for E. meleagrimitis and between 5,000 and 12,500 for E. adenoeides.

In the dose response studies dose ranges of toltrazuril varying between 3 and

14 mg/kg were compared against negative controls (not infected, not treated)

and positive controls (infected, not treated). All experimental treatments were

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replicated twice in cages or pens of 5 to 12 poults each. Toltrazuril was given in

the drinking water at days 2 and 3 post infection (PI). Weight gain and oocyst

counts were the pivotal efficacy criteria monitored. In our hands intestinal lesion

scoring, which is in turkeys far less specific and standardised than in chickens,

was not a very useful diagnostic tool. Our experience confirmed the FDA

efficacy guideline (www.fda.gov) which states that, in turkeys, body weight gain

is the most appropriate predictor and lesion scoring a poor predictor of the

severity of a coccidiosis infection. Faecal oocysts were counted between 4 and

7 days PI and final body weights were measured one day later. All together four

studies were run, one in cages, three others in floor pens.

With both Eimeria spp. the experimental challenge produced overt clinical

disease in the positive controls with total faecal oocyst outputs (number/g) of

approx. 4 to 7 log10, mostly about 6 log10, and weight gain reductions

compared to the negative controls of 32 to 65%, on average 60 % for E.

meleagrimitis and 38 % for E. adenoeides. Over the entire toltrazuril dose range

tested oocyst excretion remained below the limit of detection (67 oocyst/g). In

contrast to the severe growth depression observed in the positive controls,

weight gain of the turkey poults treated with 7 mg toltrazuril/kg for 2 days was

very close to this of the negative controls, i.e. at 77 to 97 % for E. meleagrimitis

and at 93 to 99 % for E. adenoeides. Increasing the dose from 7 to 10 or 14

mg/kg did not improve control of challenge induced weight gain depression.

The results of these 4 dose response trials were compared with those of similar

work conducted 5 years before (Roux, 1997). In the latter 2 battery dose

titration studies, the recommended dose of 7 mg/kg of a single two-day Baycox

treatment course was assessed against 14 and 21 mg/kg. Optimum efficacy

was shown for E. meleagrimitis as well as E. adenoeides at 7 mg/kg with weight

gains of 98 to 99 % compared to the negative controls and with full reduction of

oocyst shedding. Doubling or tripling the recommended 7 mg/kg dose did not

boost efficacy. The current trials and those of Roux (1997) allow to conclude

that a single treatment course of 2 days with Baycox in drinking water at 7

mg/kg is the reliable, fully efficacious dosage to control outbreaks of turkey

occidiosis.

As a toltrazuril dosage increase beyond the recommended label claim does not

improve clinical efficacy, we assume that an inherent lack of activity of this

compound is not a likely cause of suspected treatment failures. Should

incidentally treatment failures occur then other factors should be considered,

e.g. intercurrent disease, interfering bacterial complications,

immunesuppression, wrong diagnosis, inappropriate dosing, or a combinations

thereof. To learn more about possible product related treatment failures we

conducted very recently an inquiry in Europe. We found out that occasionally

cases were reported in situations when Baycox was dosed on a 25 ppm in

water basis . Actually true therapy failures were never encountered when the

product was dosed on a 7 mg/kg basis. Although under “regular” husbandry

conditions a 25 ppm dosage in the drinking water ( 1 L. Baycoxâ 2.5 % oral

solution/1000 L. water) is close to the daily recommended dose of 7 mg

toltrazuril/kg in 2 week old turkeys, an underdosage of about 20, 40 and 50 %

may be expected in turkeys aged 3, 5 and 7 weeks, respectively.

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Repeated dose and overdose animal safety trials in turkeys have shown that

Baycox at the recommended dosage has no significant effect on drug

palatabilty and bird performance. Doses up to 35 to 40 mg/kg for 2 days were

well tolerated (blood chemistry, performance). Other studies (Depta, 1985;

Mitschke, 1988) suggest or indicate that toltrazuril palatability is not significantly

impaired at drinking water dosages corresponding to daily doses lower than a

threefold overdose (21 mg/kg). All in all Baycox administered at the

recommended dosage is a very efficacious and safe drug for the treatment of

coccidiosis in growing turkeys.

References.

1. Depta G. 1985. “Untersuchungen über die Verträglichkeit von Bay Vi 9142

im Trinkwasser sowie die Kompatibilität mit den Futterzusatzstoffen

Dimetridazol, Ipronidazol und Ronidazol bei der Pute.” Inaugural

Dissertation. Tierärztliche Hochschule Hannover, Germany.

2. Edgar S.A., 1986. “Coccidiosis in turkeys: biology and incidence.” Research

in Avian Coccidiosis. Proc. of the Georgia Coccidiosis Conference, pp. 116-

123.

3. Greuel E., Mundt H.-C., Cortez S. 1991. “Zur Sulfonamid- und

Toltrazuriltherapie der experimentellen Putenkokzidiose.” Dtsch. Tierärzl.

Wschr. 98: 129-132.

4. Greuel E., Ruhrmann U., Mundt H.-C., 1989. “Untersuchungen zur

Wirksamkeit von Baycox bei experimenteller Putenkokzidiose.” Der

praktische Tierarzt 70:38-42.

5. McDougald L.R., 1998. “Intestinal protozoa important to poultry.” Poultry

Science 77: 1156-1158.

6. Mitschke U., 1988. “Verteilung, Metabolismus und Ausscheidung von

Toltrazuril in Abhängigkeit von Lebensalter und experimentellen

pathophysiologischen Veränderungen bei Hühnern und Puten.” Inaugural-

Dissertation. Tierärztliche Hochschule Hannover, Germany.

7. Pashov D., Koinarski V., 1994. “Comparative studies of anticoccidial efficacy

of sulfadimidine-trimethoprim combination, sulfadimidine and toltrazuril in

turkeys.” Proc. Eur. Assoc. Vet Pharmacol., Edinburgh, UK, page 264.

8. Roux V.J., 1997. “Contribution à l’ étude des coccidioses de la dinde: essais

thérapeutiques.” Thèse pour le Doctorat Vétérinaire. École Nationale

Vétérinaire d’ Alfort, France

9. www.fda.gov/cvm/guidance/guideline40.html. 19 pp. “Specific considerations

for evaluating the efficacy of anticoccidial drugs.”